On Monday, February 21, 2011, urologists at Peninsula Urology Associates in Salisbury, MD, opened their practice to U.S. Representative Andy Harris, MD (R-MD-1)@blurbend, to discuss the regulatory, reimbursement and legal challenges of practicing medicine in today’s healthcare landscape including physician reimbursement and access to in-office ancillary services.

The visit was coordinated by one of the practice’s urologists, Mark T. Edney, MD, FACS, who also chairs the Maryland Urologists for Patient Access and Care (MUPAC) coalition and is a member of the AUA Legislative Affairs Committee.

“It is very meaningful that Congressman Harris, a fellow physician, came to our practice and discussed the critical issues we face each day,” Dr. Edney said. “We all agree that healthcare reform is necessary, but in order for it to succeed, physician challenges must be addressed.”

Peninsula Urology has been serving patients on the Eastern Shore of Maryland for more than 50 years. The group is the sole provider of prostate surgery at Peninsula Regional Medical Center. Congressman Harris toured the on-site ambulatory surgery center (ASC) where most of Peninsula Urology’s minor surgical procedures are performed.

“I’m happy to meet with my colleagues at Peninsula Urology to discuss healthcare reform,” said Harris. “As a physician, I understand that this community-based practice is an example of how healthcare is most effectively delivered. We’ve got to make sure that [healthcare] stays affordable and that people have access to their physicians.”

Harris’ visit was part of a new effort by the AUA States & Sections Manager to encourage practices to host federal lawmakers at their practices, and to build relationships with and to educate their lawmakers about the issues that today’s urologist faces. Similar visits have taken place in Connecticut and Pennsylvania, among other states.

The AUA is pleased to announce its support for newly introduced legislation designed to address urotrauma, a growing concern among active military personnel and veterans. The bill, H.R. 1612, which would direct the U.S. Secretary of Defense to establish a commission on urotrauma, was formally introduced in mid-April by Congressmen Brett Guthrie (R-KY-2), Mike Ross (D-AR-4), Peter King (R-NY-3), Mike McIntyre (D-NC-7) and Steve Stivers (R-OH-15). The AUA worked closely with lawmakers to draft the legislation.

Urotrauma is a significant issue, particularly among active military populations. Improvised explosive devices (IEDs), when detonated, can cause severe trauma to the sexual organs and genitourinary system.@blurbend Additionally, the heavy weight of armor and gear can cause strain to the abdominal muscles over time, which can ultimately impact urinary function, leading at times to pelvic prolapse.

H.R. 1612 would establish an Interagency Commission, led by the U.S. Department of Defense, to investigate and advise on the research and action needed to advance this increasingly essential field. The urotrauma legislation includes the following key provisions:

Creation of “The National Commission on Urotrauma,” which will conduct a comprehensive study of the present state of knowledge and research on urotrauma, evaluate existing education and research resources, and identify knowledge and programmatic gaps.

A long-range plan, based on the Commission’s comprehensive study, for the use and organization of national resources to effectively deal with urotrauma, including: 1) researching innovations in the care and treatment of persons affected by urotrauma, 2) identifying ways to prevent or minimize these types of injuries, and 3) improving education and training to medical personnel caring for these individuals and to the general public.

"This bill highlights the importance of urotrauma research and treatment, and specifically addresses the medical needs of our young military service personnel returning from Iraq and Afghanistan,” said AUA Health Policy Chair Steven M. Schlossberg, MD, MBA. “Moreover, H.R. 1612 emphasizes the importance of urologic diseases and the federal government’s role in helping to promote the best quality patient care to our military.”

“We are thankful to Representatives Guthrie, Ross, King, McIntyre and Stivers for bringing the issue of urotrauma to the attention of federal leaders,” he added.

In February 2011, the Health Information Technology Policy Committee (HITPC) contacted the Office of the National Coordinator for Health Information Technology (ONCHIT) recommending changes to the Meaningful Use of electronic health records (EHRs) requirements – Stages 2 and 3.@blurbend These recommendations included increasing the performance percentage for some of the Stage 1 measures, and converting some of the Stage 1 menu measures (optional) to core measures (required). Almost universally, organized medicine and providers, who are both attempting to carry out the Stage 1 measures in 2011, believe that the HITPC is moving too fast and that EHR users are not ready to move to the next stage so quickly.

Recent Study Published in Health Affairs Reports Total Costs of EHR
A research study funded by the Agency for Healthcare Research and Quality (AHRQ), published in the March edition of Health Affairs, pegs the total first-year cost for a five-physician practice to implement an EHR system at $46,659. These costs include acquisition of hardware and software, maintenance fees, and infrastructure modifications among others.

Registrations for Meaningful Use Incentive Top 21,000 in First Month
The Centers for Medicare & Medicaid Services launched the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs registration page on January 1, 2011, and the agency reports that 21,000 registrations were processed by the end of January. To register, each provider is required to have not only a National Provider Identifier (NPI) but also a Web account with the National Plan and Provider Enumeration System (NPPES), including a personal log-in and password, and this has caused some confusion. Although many providers obtained their NPIs using the Provider Enrollment, Chain and Ownership System (PECOS), they did not necessarily create a user account with a log-in and password at that time. Often, the office manager created one account to enroll the entire group of providers but that log-in and password is not linked to the individual NPIs. Therefore, many providers are now completing that step in order to enroll successfully.

We are taking advantage of the 2011 Annual Meeting’s Washington, DC, location by hosting an “Afternoon on the Hill”—an opportunity for those who have registered for this specific event to advocate for urology on Capitol Hill on Wednesday, May 18, 2011. Participants will meet with their Senators and staff in order to let them know what is important to urology.

Registration for this event closed on April 18, 2011. However, if you did not register and are interested in participating, stop by the UROPAC booth, located on the street level of the grand lobby (next to Starbucks) in the Walter E. Washington Convention Center. Staff will give you more details on the event and answer your questions.@blurbend Additionally, they will maintain a waiting list in case there are any last minute openings.

If you did register to participate, don’t forget! You do not want to miss this historic AUA event.

Don’t have time to participate in “Afternoon on the Hill” but still want to let Congress know you were in DC? Join us for a group photo at the U.S. Capitol on Wednesday, May 18, 2011, at 1:15 p.m. The photo will show the Administration and Members of Congress that urology had a strong presence in Washington, DC, and is a force with which to contend. All Annual Meeting attendees are welcomed and encouraged to be in the photo. If you are only participating in the photo, you are responsible for your own transportation to and from this event. Meet us at Garfield Circle on the west side of the Capitol at 1:15 p.m. We will be finished by 1:45 p.m. AUA staff will be there to assist you.